​Soccer fans were shocked by the sudden passing of reporter Grant Wahl as he covered the World Cup in Qatar. The mystery around his death was cleared-up when the autopsy determined that the 49-year-old suffered a ruptured aortic aneurysm. Aortic aneurysms are rare for people Wahl's age and with his general health. So, the circumstances of his passing may have you wondering how it happened and what could have been done.  

"It's always shocking when somebody as young and as healthy as Grant Wahl dies," says Geoffrey Answini, MD, a thoracic and cardiac surgeon with The Christ Hospital Physicians – Heart & Vascular. "Unfortunately, it's something that we have to be aware of because aortic aneurysms are silent killers. People need to be aware of the risk factors."

What is an aortic aneurysm?

An aortic aneurysm is a balloon-like bulge in the aorta, the large artery that carries blood from the heart to the rest of the body. An aneurysm can weaken the aorta wall to the point where it can leak, tear or rupture. There are approximately 15,000 deaths in the U.S. each year due to aortic aneurysms, with leaks and ruptures being the cause of most. Aortic aneurysms are more common in men, and people 65 years of age or older, according to the U.S. Centers for Disease Control & Prevention. 

The location and size of an aortic aneurysm can increase the likelihood of death, and they often go undiagnosed until it is too late, hence the phrase "silent killer." However, they are treatable when detected on time, which is why Dr. Answini urges patients to know the risk factors and whether they apply to them, and to be screened for aneurysms if they do apply. 

Risk factors for aortic aneurysms

"An aortic aneurysm can develop and exist over a long period of time," says Dr. Answini. "Many people aren't aware of any symptoms until it's too late. It's very important for people to know the associated risk factors and to seek screening if they meet the risks."

The leading risk factors for an aortic aneurysm are:

• Smoking
• Uncontrolled high blood pressure
• Family history of aortic aneurysms
• Coronary artery disease where you have had multiple stents or bypass surgery

"Smoking is by far the leading risk factor," Dr. Answini says. "If you're over the age of 60 and if you've smoked at least 100 cigarettes in your life, you should get screened. You should also seek out screening if you're in this age group and have had issues with uncontrolled high blood pressure or have had other known blockages."

Dr. Answini points out the complication of Grant Wahl's case because he didn't fall into the usual risk factors for aortic aneurysms.

"We don't know for sure in his case, but many otherwise healthy individuals may be at increased risk due to genetic tissue disorders such as Marfan syndrome or Ehlers-Danlos syndrome," he says. "These disorders can weaken the tissues in your arteries and increase the likelihood of a bulge that could lead to a rupture. Genetic counseling can help identify markers associated with the risk of an aortic aneurysm. If those are detected, you should get screening regardless of other risk factors."

Screening and treatment of aortic aneurysm

Dr. Answini points out that like many heart and vascular conditions, early diagnosis increases the chance of surviving an aortic aneurysm. That's why screening is vital to those who meet the risk factors. Aortic aneurysms are detectable through a variety of imaging tests including:

• Ultrasound
• Chest X-ray
• Echocardiogram
• CT scan
• MRI

"Screening is affordable, non-invasive and convenient," he says. "So, if you are at risk, I urge you to be screened. We offer heart and vascular screening at The Christ Hospital for only $75. That's not a lot for a painless, 20-minute screening that could save your life."

He also mentions that patients who schedule a "Welcome to Medicare" exam can also be screened.

Treatment for aortic aneurysms can help them​ from growing or rupturing and in some cases repair them. Treatment options include:

• Regular monitoring for changes in size and shape.
  
• Medical management with prescription medications to lower high blood pressure and cholesterol.
• Surgical treatment including endovascular repair via a stent-graft, open-aneurysm surgery, or a hybrid of both. 
• Lifestyle changes such as smoking cessation, managing weight and diet and reducing the impact of stress.

"The lifestyle management is very important to not only reducing risks after diagnosis," Dr. Answini says. "It's the key to prevention and knowing when to be screened. Ask your doctor for guidance if you feel that you are at increased risk due to your lifestyle."